运动疗法对2型糖尿病病人血糖影响的研究进展

运动疗法是公认的可有效预防并控制2型糖尿病发生和发展的方法。对此作者主要论述运动疗法对2型糖尿病病人血糖的影响,包括运动的方法、强度、频率和时间。     

Fuel and fluid homeostasis during long-term exercise in healthy subjects and type I diabetic patients.

OBJECTIVE--This study was designed to examine metabolic and hormonal effects of long-term exercise in healthy subjects and insulin-dependent (type I) diabetic patients. RESEARCH DESIGN AND METHODS--Two studies were performed. First, 16 healthy males (32 +/- 3 yr) were studied during a semitriathlon competition (2 km swimming, 90 km biking, and 21 km running). Second, 9 type I diabetic males (41 +/- 2 yr) and 17 healthy matched control subjects were studied during a 75 km cross-country skiing race. Blood samples were taken before and immediately after exercise, and also during the ski race. RESULTS--During the semitriathlon race, serum insulin, C-peptide, glucagon cortisol, growth hormone ACTH, prolactin, and plasma renin activity increased two- to ninefold, whereas serum testosterone fell. Apart from a fall in magnesium, serum electrolyte concentrations remained unchanged. Before long-term skiing, patients reduced their insulin dose by 30-40%. They were hyperglycemic during the initial part of the race, but near normoglycemic thereafter. There were large interindividual variations in the increments of counterregulatory hormones, whereas serum testosterone and luteinizing hormone fell quite uniformly. Plasma renin activity and aldosterone concentrations rose similarly in diabetic and healthy subjects, whereas the rise in antidiuretic hormone was slightly greater in diabetic patients. During the initial part of the race, serum atrial natriuretic peptide fell in both groups. CONCLUSIONS--Severalfold increments in hormone concentrations contribute to the maintenance of fuel and fluid homeostasis during long-term exercise. With an appropriate adjustment of insulin dose and diet, also type I diabetic patients can participate in competitive long-term exercise.     

八段锦对2型糖尿病患者血糖控制效果的影响

目的探讨八段锦对2型糖尿病患者血糖控制效果的影响。方法选取2型糖尿病患者60例进行八段锦运动6个月,每周日观察5点血糖谱变化,并监测患者运动前、运动1、3、6个月后糖化血红蛋白(HbA1c)。结果与运动前相比,运动1、3、6个月后本组患者HbA1c分别下降了4.0%、8.0%、11.2%;早餐后和午餐后血糖在运动后第2周开始下降(P<0.01),空腹和晚餐后血糖在运动后第4周开始下降(P<0.05),睡前血糖则在运动后的第6周开始下降(P<0.05);同时血糖标准差和空腹血糖变异系数也有显著下降(P<0.01)。结论八段锦能平稳降低2型糖尿病患者日内各点血糖和HbA1c值,为2型糖尿病患者提供了一种安全、平稳控制血糖的运动方法。     

盐酸吡格列酮对磺脲类和双胍类药物联合治疗失效的2型糖尿病患者的疗效观察

目的观察盐酸吡格列酮对磺脲类和双胍类药物联合治疗而血糖仍未控制的2型糖尿病患者的降糖作用。方法采用随机双盲、安慰剂平行对照研究。45例符合入选条件的患者随机分入吡格列酮组或安慰剂组,为期12周双盲期治疗。试验开始和结束日测定患者空腹血糖(FPG)、血清胰岛素(FINS)、总胆固醇(TC)、甘油三酯(TG)、高密度脂蛋白胆固醇(HDL-C)和糖化血红蛋白(HbA1c)以及标准餐后2h血糖(PG2h)和胰岛素(INS2h)。胰岛素敏感性采用HOMA-model公式评价。结果在基线时吡格列酮组和安慰剂组患者的平均年龄、病程、体重指数、血压、FPG、PG2h、FINS、INS2h、HbA1c和血脂差异无显著性。12周时吡格列酮组的FPG平均下降幅度显著大于安慰剂组[分别为(-1.94±1.24)mmol/L和(-1.15±1.22)mmol/L,P<0.05]。吡格列酮组12周时PG2h、HbA1c、TG、TC和HDL-C均较治疗前显著下降,但组间比较只有PG2h存在显著差异。吡格列酮组胰岛素抵抗指数(HOMA-IR)显著低于安慰剂组(1.30±0.90与2.55±1.61,P<0.01)。结论盐酸吡格列酮可改善磺脲类和双胍类药物联合治疗血糖仍未达标的2型糖尿病患者的血糖水平,提高胰岛素敏感性。     

健康教育对2型糖尿病病人血糖的影响

随着社会经济的发展,生活质量的改变,糖尿病患病率急剧上升,成为世界上四大慢性病之一[1],其发病率高,并发症多,往往影响病人生活质量。因此,糖尿病的治疗备受关注,但仅仅依靠药物控制血糖是不够的,还应注重健康教育。本研究的目的是探讨健康教育对糖尿病病人血糖的影响。     

健康教育对2型糖尿病病人血糖的影响

随着社会经济的发展,生活质量的改变,糖尿病患病率急剧上升,成为世界上四大慢性病之一[1],其发病率高,并发症多,往往影响病人生活质量。因此,糖尿病的治疗备受关注,但仅仅依靠药物控制血糖是不够的,还应注重健康教育。本研究的目的是探讨健康教育对糖尿病病人血糖的影响。     

Elevated remnant-like lipoprotein particles in impaired glucose tolerance and type 2 diabetic patients.

OBJECTIVE: Impaired glucose tolerance (IGT) in association with insulin resistance is considered to be a risk factor for atherosclerosis. Thus, patients with IGT may have abnormal lipid and lipoprotein profiles. The purpose of this study was to investigate presence of remnant-type hyperlipoproteinemia in patients with IGT. RESEARCH DESIGN AND METHODS: Serum levels of remnant-like lipoprotein particles (RLP) were measured in 541 subjects (362 men and 179 women, age 53 +/- 7.9 years) who visited our health center for routine medical examinations. We measured RLP cholesterol (RLP-C) and RLP triglycerides (RLP-TG) using immunoaffinity gel containing monoclonal anti-human apoproteins A-I (H-12) and B-100 (JI-H) antibodies. After a 75-g oral glucose tolerance test, subjects were divided into three groups: normal, IGT, and type 2 diabetic. RESULTS: After matching for sex, age, and body weight, serum RLP-C in normal, IGT, and diabetic groups were 4.2 +/- 1.7, 6.2 +/- 3.4, and 6.2 +/- 4.2 mg/dl, respectively. The corresponding RLP-TG values were 16.7 +/- 9.2, 28.0 +/- 19.1, and 29.0 +/- 27.2 mg/dl. We found that RLP-C and RLP-TG values were significantly higher in the IGT and diabetic groups compared with the normal group (P < 0.001). In the same order, total serum cholesterol levels were 206 +/- 29, 205 +/- 34, and 206 +/- 34 mg/dl and LDL cholesterol levels were 127 +/- 27, 124 +/- 34, and 123 +/- 34 mg/dl, showing no marked difference in these groups. However, serum levels of triglyceride were higher in the IGT and diabetes groups (155 +/- 76 and 151 +/- 81 mg/dl vs. 106 +/- 41 mg/dl; P < 0.0001). Further, the incidence of remnant hyperlipoproteinemia in normocholesterolemic subjects was up to four times higher in IGT and diabetic groups compared with the normal group. CONCLUSIONS: High serum RLP-C and RLP-TG levels in IGT and diabetic patients may represent an increased risk of atherosclerosis in these patients.     

Effects of arm exercise on serum glucose response in type 2 DM patients

The aims of the study were to examine the influence of upper extremity exercise on glucose response and to establish a predictive model of changes in serum glucose under different exercise intensities and durations. Thirty-three type 2 DM patients who met the selection criteria were selected. An arm cycle ergometer exercise test was conducted, and then 12 arm exercise sessions were arranged based on different exercise intensities (40%, 60%, and 80% of maximal workload) and exercise durations (10, 20, 30, and 40 min). Serum glucose levels were measured before and after each exercise session. Serum glucose levels significantly decreased after arm exercise regardless of different intensities or durations. However, no interaction effect (intensity x duration) or main effect in exercise intensity was observed, but a significant main effect in exercise duration was observed (F = 11.756, p <.0001). Also exercise duration was a significant predictor of serum glucose changes after arm exercise. These results suggest that arm exercise can play a useful role in glycemic control for type 2 DM patients and exercise duration is a key factor in determining serum glucose response under upper-extremity exercise.     

Homeostasis model assessment as a clinical index of insulin resistance in type 2 diabetic patients treated with sulfonylureas.

OBJECTIVE: To investigate whether the insulin resistance index (IR) assessed by homeostasis model assessment (HOMA) is associated with the insulin resistance index assessed by euglycemic-hyperinsulinemic clamp (clamp IR) in type 2 diabetic patients who received sulfonylureas (SUs), as well as in those treated by diet alone. RESEARCH DESIGN AND METHODS: Retrospectively, the association between HOMA IR and clamp IR was analyzed in 80 type 2 diabetic subjects (53 subjects treated with SUs and 27 subjects treated with diet alone). The 80 subjects, selected because they had not received insulin therapy, were among 111 diabetic participants in a clamp study for evaluation of insulin resistance from May 1993 to December 1997 in Osaka City University Hospital. RESULTS: The HOMA IR showed a hyperbolic relationship with clamp IR. The log-transformed HOMA IR (all subjects, r = -0.725, P < 0.0001; SU group, r = -0.727, P < 0.0001; diet group, r = -0.747, P < 0.0001) correlated more strongly with clamp IR than did HOMA IR per se (all subjects, r = -0.594, P < 0.0001; SU group, r = -0.640, P < 0.0001; diet group, r = -0.632, P = 0.0004). The univariate regression line between log-transformed HOMA IR and clamp IR in the SU group did not differ from that in the diet group (slope, -6.866 vs. -5.120, P > 0.05; intercept, 6.566 vs. 5.478, P > 0.05). Stepwise multiple regression analyses demonstrated that the log-transformed HOMA IR was the strongest independent contributor to clamp IR (R2 = 0.640, P < 0.0001). CONCLUSIONS: The HOMA IR strongly correlated with the clamp IR in type 2 diabetic patients treated with SUs as well as in those treated with diet alone.     

Interaction of insulin and exercise on glucose transport in muscle.

Glucose transport is the rate-limiting step for glucose utilization in muscle. In muscle and adipose tissue, glucose transport is acutely regulated by such factors as insulin and exercise. Translocation of glucose transporters (GLUT4) from an intracellular domain to the cell surface is the major mechanism for this regulation. Using immunocytochemistry, the intracellular distribution of GLUT4 under resting conditions is similar in adipocytes and myocytes. GLUT4 is concentrated in tubulovesicular structures either in the trans-Golgi region or in the cytosol, often close to the cell surface but not on the cell surface. After stimulation, cell surface GLUT4 labeling is increased by as much as 40-fold. GLUT4 is chronically regulated by altered gene expression. Neural and/or contractile activity regulates GLUT4 expression in muscle: 1) GLUT4 levels differ among muscles of different fiber type; 2) GLUT4 levels in muscle are increased with exercise training and decreased with denervation; and 3) cultured muscle cells, which lack an intact nerve supply, express very low levels of GLUT4. GLUT4 expression appears to be regulated in parallel with many oxidative enzymes in muscle, suggesting that there may be a unified developmental program that determines the overall metabolic properties of a particular muscle. Preliminary evidence suggests that impaired GLUT4 expression in muscle is not the primary defect associated with insulin resistance. Nevertheless, it is conceivable that the adaptive increase in muscle GLUT4 that is found with exercise training may have beneficial effects in insulin-resistant states such as non-insulin-dependent diabetes.     

血糖波动与2型糖尿病大血管并发症

随着糖尿病患病率的攀升,糖尿病并发症发病率也大大升高,人们也越来越重视糖尿病并发症尤其是大血管并发症的预防及控制。国内外大型研究均显示,血糖波动是大血管病变的危险因素,其导致大血管病变的发生、发展机制及相关的治疗策略也逐渐被深入研究。目前,血糖波动已成为评价2型糖尿病大血管并发症的重要指标之一。该文对血糖波动及其与大血管并发症的相关研究进行综述,为2型糖尿病患者的临床治疗提供参考。     

Postabsorptive and insulin-stimulated energy homeostasis and leucine turnover in offspring of type 2 diabetic patients

OBJECTIVE: This study was performed to ascertain whether insulin resistance with respect to protein metabolism is an additional primary metabolic abnormality affecting insulin-resistant offspring of type 2 diabetic parents, along with insulin resistance with respect to glucose and lipid metabolism. RESEARCH DESIGN AND METHODS: We studied 18 young, nonobese offspring of type 2 diabetic parents and 27 healthy matched (by means of dual-energy X-ray absorption) individuals with the bolus plus continuous infusion of [6,6-(2)H(2)]glucose and [1-(13)C]leucine in combination with the insulin clamp (40 mU x m(-2) x min(-1)). RESULTS: Fasting plasma leucine, phenylalanine, alanine, and glutamine concentrations, as well as the glucose and leucine turnover (reciprocal pool model: 155 +/- 10 vs. 165 +/- 5 micromol x kg lean body mass(-1) x h(-1) in offspring of type 2 diabetic patients and healthy matched individuals, respectively), were also not different. During the clamp, glucose turnover rates were significantly reduced in offspring of type 2 diabetic patients (7.1 +/- 0.5) in comparison with healthy matched individuals (9.9 +/- 0.6 mg x kg lean body mass(-1) x min(-1); P < 0.01). Also, the suppression of leucine turnover was impaired in offspring of type 2 diabetic patients (12 +/- 1%) in comparison with healthy matched individuals (17 +/- 1%; P = 0.04) and correlated with the degree of the impairment of insulin-stimulated glucose metabolism (R(2) = 0.13; P = 0.02). CONCLUSIONS: Nonobese, nondiabetic, insulin-resistant offspring of type 2 diabetic patients were characterized by an impairment of insulin-dependent suppression of protein breakdown, which was proportional to the impairment of glucose metabolism. These results demonstrate that in humans, a primary in vivo impairment of insulin action affects glucose and fatty acid metabolism as previously shown and also protein/amino acid metabolism.     

运动疗法干预2型糖尿病患者的情绪及其睡眠质量

目的:观察运动疗法干预对2型糖尿病患者情绪及睡眠质量的影响。方法:以2003-01/2004-01安阳钢铁集团公司职工总医院内科收治的2型糖尿病患者为观察对象。纳入者均符合1997年美国糖尿病学会标准。共纳入40例,随机分为运动组与对照组各20例。运动组常规治疗下开展计划性运动训练,运动形式:功率车、舞蹈及户外慢跑、步行、骑自行车、爬楼梯等有氧运动。运动强度:运动后靶心率达到170减年龄;以运动后有微汗、轻松愉快,食欲、睡眠良好。运动时间:一般选择在餐后1h,每周三四次,1h/次,也可分3次活动,20min/次,达到靶心率的累计时间一般以20～30min为宜。预备时间不少于10min,运动后的整理运动10～15min。对照组治疗方式与运动组相同,但不参加运动训练,而以个人意愿进行活动。运动前后均采用睡眠质量调查量表及症状自评量表评估患者睡眠质量及心理情绪。结果:按意向性处理分析,40例患者均参与该项实验,无脱落者。实验前运动组与对照组症状自评量表及睡眠质量总分调查表评估结果基本相同,两组患者入院时空腹血糖、餐后2h血糖进行比较,具有可比性(P>0.05)。运动组2型糖尿病患者运动后的情绪改善明显,症状自评量表总分值(135.83±24.68)明显低于对照组(152.99±26.56)(t=2.59,P<0.05)。运动后2型糖尿病患者睡眠情况明显改善,睡眠质量总分为(3.38±0.69),明显低于对照组(5.02±0.86)(t=3.88,P<0.01)。运动后患者空腹及餐后2h血糖值为(6.30±1.32),(7.80±1.44)mmol/L,均低于对照组犤(7.75±1.81),(9.51±1.86)mmol/L犦(t=3.06,3.23,P<0.01)。结论:运动疗法不仅具有降糖作用,对2型糖尿病患者情绪及睡眠质量也有积极的影响。     

动机性访谈在2型糖尿病患者运动疗法中的应用

目的:探讨动机性访谈(MI)在2型糖尿病患者运动疗法中的应用效果。方法:将60例2型糖尿病患者随机分为对照组和观察组各30例,均进行运动疗法指导。对照组给予常规健康教育,观察组给予MI。比较两组干预前后空腹血糖(FPG)、餐后2 h血糖(2 hPG)、糖化血红蛋白(HbA1c)、体质指数(BMI)及运动依从性、生活质量评分。结果:观察组干预后FPG、2 hPG、HbA1c、BMI及运动依从性均优于对照组(P<0.05),生活质量中生理功能、心理精神、社会关系评分及总分与对照组比较差异有统计学意义(P<0.05,P<0.01)。结论:MI能有效提高2型糖尿病患者的运动依从性,改善病情,提高生活质量。     

短期强化教育对2型糖尿病患者血糖控制的影响

目的探讨对新确诊的2型糖尿病患者进行有效健康教育的方式,提高血糖控制水平。方法将100例新确诊的2型糖尿病门诊患者分为短期强化教育组(A组)50例和一般教育组(B组)50例,采用不同的教育方法,观察教育前和教育后3个月两组的糖尿病知识评分和空腹血糖、餐后2h血糖、糖化血红蛋白。结果与教育前比较,教育后3个月A组糖尿病知识和自我管理能力评分明显提高;与B组比较,A组糖化血红蛋白指标明显下降,差异有显著性统计学意义。结论对新确诊的2型糖尿病患者实施短期强化教育,可以提高患者对疾病的认知水平和自我管理能力,有利于患者的血糖控制。     

针对性营养护理对2型糖尿病病人血糖的影响

[目的]探讨针对性营养护理对2型糖尿病病人血糖控制的影响。[方法]将60例2型糖尿病病人随机分为对照组和观察组各30例,对照组采用常规治疗,观察组在常规治疗基础上进行针对性营养护理,均治疗3个月。治疗前后分别测量两组病人的空腹血糖、餐后2h血糖及糖化血红蛋白值。[结果]治疗后两组空腹血糖、餐后2h血糖及糖化血红蛋白均较治疗前下降(P0.05);治疗后观察组空腹血糖、餐后2h血糖及糖化血红蛋白较对照组下降更为明显(P0.05)。[结论]针对性营养护理更有利于2型糖尿病病人的血糖控制。     

2型糖尿病病人血糖达标率的研究进展

2型糖尿病是一种常见、慢性终身性疾病,但是病人血糖达标率普遍较低.本研究从血糖达标率和依从性的定义、血糖达标率的现状、血糖达标率对并发症的影响、血糖达标率的影响因素及干预等方面综述了2型糖尿病病人血糖达标率的研究进展.     

康复运动处方锻炼对2型糖尿病患者血糖、血脂与体质指标的影响

目的：观察按康复运动处方进行24周的运动锻炼对2型糖尿病患者血糖、血脂与体质指标的影响.方法：采用医院病历收集法,选择2002-03/2004-03到厦门市第一人民医院、厦门市中山医院、厦门市第二人民医院收治的无运动禁忌证的2型糖尿病患者58例,进行为期24周的康复运动处方干预治疗.①第1～6周：运动强度50%～60%最大心率,主观运动强度为9～10,锻炼方法为开始部分＋快走15 min＋（跑60 s＋快走30 s）&;#215;6＋快走10 min＋慢走8 min＋肌肉抗阻练习＋结束部分.②第7～12周：运动强度65%最大心率,主观运动强度为11,锻炼方法为开始部分＋快走10 min＋（跑60 s＋快走30 s）&;#215;2＋（跑75s＋快走30 s）&;#215;6＋快走8 min＋慢走8 min＋肌肉抗阻练习＋结束部分.③第13～18周：运动强度70%最大心率,主观运动强度为12,锻炼方法为开始部分＋快走10 min＋（跑60 s＋快走30 s）&;#215;2＋（跑75 s＋快走30 s）&;#215;8＋快走10 min＋慢走10 min＋肌肉抗阻练习＋结束部分.④第19～24周：运动强度75%最大心率,主观运动强度为13,锻炼方法为开始部分＋以8 km/h速度跑完2.5 km,中间可以快走方式间歇1次,间歇不超过1 min＋慢走2 min＋肌肉抗阻练习＋结束部分.每周5 d,每日早、晚各1次,75 min/次.锻炼开始前1周内和锻炼结束后1周内测定患者的体质指标（包括体质量指数、腰臀比、肺活量、握力、静态心率和血压）、血脂和血糖.结果：58例患者完成训练进入结果分析.①体质指标：体质量指数、腰臀比和静态心率均较治疗前显著降低（P均＜0.01）;收缩压和舒张压均降到正常范围（P＜0.05）;而肺活量、握力和座位体前屈距离均显著增加（P均＜0.01）.②血糖指标：空腹血糖、葡萄糖负荷试验2 h后血糖和糖化血红蛋白均较治疗前显著降低[（6.18&;#177;1.79）,（12.13&;#177;4.23）mmoL/L;（10.66&;#177;2.47）,（17.76&;#177;6.50）mmol/L;（7.47&;#177;1.67）%,（10.57&;#177;1.87）%;P均＜0.01].③血脂指标：三酰甘油、总胆固醇、和总胆固醇/高密度脂蛋白胆固醇均显著降低（P均＜0.01）,而高密度脂蛋白胆固醇却较治疗前显著升高（P＜0.05）.结论：长期、系统、有针对性的康复运动处方锻炼可显著增强糖尿病患者体质,改善血糖和血脂指标,对糖尿病的治疗有重要作用.     

应用计步器指导2型糖尿病病人运动效果分析

[目的]调查使用计步器能否有效指导糖尿病病人科学运动降低血糖,预防运动过量而致的低血糖。[方法]将60例2型糖尿病病人随机分为两组,第一周期两组均不使用计步器指导运动;第二周期观察组病人运动时携带计步器,对照组不使用计步器指导运动,观察两组病人不同周期3餐后2h血糖达标率及低血糖发生率。[结果]第二周期观察组血糖达标率为80.0%,对照组为23.3%;观察组低血糖发生率为0.9%,对照组为4.7%,两组比较差异均有统计学意义（P〈0.05）。[结论]使用计步器指导糖尿病病人运动,能够有效帮助病人达成运动目标,控制餐后2h血糖,同时预防运动过量,减少低血糖的发生。     

康复运动处方锻炼对2型糖尿病患者血糖、血脂与体质指标的影响

目的:观察按康复运动处方进行24周的运动锻炼对2型糖尿病患者血糖、血脂与体质指标的影响。方法:采用医院病历收集法,选择2002-03/2004-03到厦门市第一人民医院、厦门市中山医院、厦门市第二人民医院收治的无运动禁忌证的2型糖尿病患者58例,进行为期24周的康复运动处方干预治疗。①第1～6周:运动强度50%～60%最大心率,主观运动强度为9～10,锻炼方法为开始部分+快走15min+(跑60s+快走30s)×6+快走10min+慢走8min+肌肉抗阻练习+结束部分。②第7～12周:运动强度65%最大心率,主观运动强度为11,锻炼方法为开始部分+快走10min+(跑60s+快走30s)×2+(跑75s+快走30s)×6+快走8min+慢走8min+肌肉抗阻练习+结束部分。③第13～18周:运动强度70%最大心率,主观运动强度为12,锻炼方法为开始部分+快走10min+(跑60s+快走30s)×2+(跑75s+快走30s)×8+快走10min+慢走10min+肌肉抗阻练习+结束部分。④第19～24周:运动强度75%最大心率,主观运动强度为13,锻炼方法为开始部分+以8km/h速度跑完2.5km,中间可以快走方式间歇1次,间歇不超过1min+慢走2min+肌肉抗阻练习+结束部分。每周5d,每日早、晚各1次,75min/次。锻炼开始前1周内和锻炼结束后1周内测定患者的体质指标(包括体质量指数、腰臀比、肺活量、握力、静态心率和血压)、血脂和血糖。结果:58例患者完成训练进入结果分析。①体质指标:体质量指数、腰臀比和静态心率均较治疗前显著降低(P均<0.01);收缩压和舒张压均降到正常范围(P<0.05);而肺活量、握力和座位体前屈距离均显著增加(P均<0.01)。②血糖指标:空腹血糖、葡萄糖负荷试验2h后血糖和糖化血红蛋白均较治疗前显著降低[(6.18±1.79),(12.13±4.23)mmol/L;(10.66±2.47),(17.76±6.50)mmol/L;(7.47±1.67)%,(10.57±1.87)%;P均<0.01]。③血脂指标:三酰甘油、总胆固醇、和总胆固醇/高密度脂蛋白胆固醇均显著降低(P均<0.01),而高密度脂蛋白胆固醇却较治疗前显著升高(P<0.05)。结论:长期、系统、有针对性的康复运动处方锻炼可显著增强糖尿病患者体质,改善血糖和血脂指标,对糖尿病的治疗有重要作用。